17 Nov Brain Network Connected To Consciousness and Awareness Identified
MedicalResearch.com Interview with:
Michael D. Fox, MD, PhD
Assistant Professor in Neurology
Berenson-Allen Center for Noninvasive Brain Stimulation
Division of Cognitive Neurology, Department of Neurology
Beth Israel Deaconess Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Consciousness is thought to be composed of arousal plus awareness, but no one knows where these processes live in the human brain.
We took a unique approach to this question by studying human brain lesions that disrupt consciousness and cause coma.
We found one small spot in the brainstem that was specific for coma (i.e. lesions that hit this spot caused coma while lesions that didn’t hit the spot did not cause coma).
In other words, there was one spot in the human brainstem that, when lesioned, disrupted arousal and caused coma
We then looked at the connectivity of that brainstem spot, and found that it was connected to two cortical regions previously implicated in awareness. These cortical regions also contained a unique type of brain cell thought only to be present in higher order mammals that are self-aware.
To confirm our findings, we looked at the integrity of our network in patients with disorders of consciousness (e.g. persistent vegetative state) and found selective disruption of this network.
MedicalResearch.com: What should readers take away from your report?
Response: There is a spot in the human brainstem that is necessary for arousal, and this spot is connected to higher order cortical regions involved in awareness.
Because arousal + awareness = consciousness, we believe this brain network may be critical in maintaining human consciousness.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Findings should be confirmed in other datasets with more brain lesions. Results can be tested in other patients that become unconscious (e.g. epilepsy patients).
Ultimately, we hope identification of this brain network will help patients with disorders of consciousness, possibly serving as a target for brain stimulation.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
A human brain network derived from coma-causing brainstem lesions
David B. Fischer, MD*, Aaron D. Boes, MD, PhD, Athena Demertzi, PhD, Henry C. Evrard, PhD, Steven Laureys, PhD, Brian L. Edlow, MD, Hesheng Liu, PhD, Clifford B. Saper, MD, PhD, Alvaro Pascual-Leone, MD, PhD,Michael D. Fox, MD, PhD‡ and Joel C. Geerling, MD, PhD‡
Published online before print November 4, 2016, doi: http://dx.doi.org/10.1212/WNL.0000000000003404Neurology 10.1212/WNL.0000000000003404
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